General Remarks

Efficacy and limitations of prenatal diagnosis

Tatsuo Kuroda
Department of Surgery, National Center for Child Health and Development

Abstract

　Recent advance of prenatal diagnostic techniques has enabled more precise assessment of fetal diseases than before. Fetal images and their perinatal courses in the representative surgical diseases treated in our department were reviewed and presented in the current study. On the other hand, evaluation of fetal imaging is not yet reliable enough to predict the perinatal risks accurately in some of the diseases. In fetal lung abnormalities, 55％ of the cystic lesions were diagnosed as CCAM in our series ; however, pathological study confirmed that only 60％ of these lesions actually showed adenomatoid histology. Nevertheless, real CCAM lesions appeared to be associated with high risk more frequently than non-CCAM lesions. In abdominal abnormalities, intestinal atresias and imperforate anus were correctly diagnosed in only 60〜70％ of the suspected cases. Complicated genitourinary abnormalities were hardly assessed prenatally, especially in females. Knowledge is still lacking regarding the peculiar images and perinatal courses in many fetal diseases. Further investigation should be directed to build an imaging database in relation to the natural history of fetal diseases. More predictive prenatal diagnosis may evoke a drastic development of prenatal intervention in some of these diseases.

Keywords：Prenatal diagnosis, Fetal imaging, Fetal intervention